Paediatric Endocrinology Unit, Department of Pediatrics, Poitiers University Teaching Hospital, France.
Ann Endocrinol (Paris). 2011 Jun;72(3):218-23. doi: 10.1016/j.ando.2011.01.002. Epub 2011 Jun 8.
To audit the contribution of plasma IGF-PB3 measurement to the diagnosis of growth hormone deficiency (GHD) in children.
Retrospective case study including boys and girls aged 0 to 18 years who attended our paediatric endocrinology clinic for short stature and/or post-irradiation follow-up, and had at least one GH provocative testing. Children with hypothyroidism, Laron or Kowarski syndromes, severe malnutrition, chronic renal failure and liver failure were excluded.
Fifty-eight children were enrolled and grouped as GHD [+] (19 cases) and GDH [-] (39 cases). IGF-I and IGF-BP3 assay was carried out in 88% and 62% cases respectively, both groups were comparable for age, sex, BMI, target height, pubertal stage and bone age. There was a significant difference in peak GH between GDH [-] and GHD [+] groups (41.8 mUI/L ± 21.7 versus 11.5 ± 5.9 mUI/L, P<0.00001, respectively). No difference was found between groups with regards to IGF-I Z-scores and IGF-BP3 Z-scores. There was, however, a positive correlation between IGF-I Z-scores and IGF-BP3 Z-scores (r=0.50; P<0.0016). IGF-BP3 measurement could not differentiate between GHD [+] and GHD [-] groups.
Measurement of plasma IGF-BP3 level contributes poorly to the diagnosis of GHD. We do not recommend it in routine use.
评估 IGF-PB3 测量对儿童生长激素缺乏症（GHD）诊断的贡献。
回顾性病例研究，纳入了年龄在 0 至 18 岁之间，因身材矮小和/或放射治疗后随访而就诊于儿科内分泌科的男孩和女孩，他们至少进行了一次 GH 激发试验。排除患有甲状腺功能减退症、Laron 或 Kowarski 综合征、严重营养不良、慢性肾衰竭和肝功能衰竭的儿童。
共纳入 58 例儿童，分为 GHD [+]组（19 例）和 GDH [-]组（39 例）。分别对 88%和 62%的病例进行了 IGF-I 和 IGF-BP3 检测，两组在年龄、性别、BMI、靶身高、青春期阶段和骨龄方面无显著差异。GH 峰值在 GDH [-]和 GHD [+]组之间存在显著差异（分别为 41.8 mUI/L ± 21.7 和 11.5 ± 5.9 mUI/L，P<0.00001）。IGF-I Z 评分和 IGF-BP3 Z 评分在两组之间无差异。然而，IGF-I Z 评分和 IGF-BP3 Z 评分之间存在正相关（r=0.50；P<0.0016）。IGF-BP3 测量不能区分 GHD [+]和 GHD [-]组。
IGF-PB3 水平的测量对 GHD 的诊断贡献较小。我们不建议常规使用它。
